CMSRN
CMSRN is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
CMSRN is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
10 sample questions for the CMSRN, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.
Sections covered on the exam: Patientsafety, Pressureinjury, Infectionprevention, Medicationsafety, Patient/Care Management, Pulmonarypharmacology, Painmanagement, Perioperativecare, Nutritionsupport, Patientadvocacy, Holistic Patient Care, Patienteducation, Healthscreening, Supportgroups, Professional Concepts, Elements of Interprofessional Care, Iii. Elements Of Interprofessional Care, Physicalassessment, Strokecare, Transitionsofcare, Informatics, Iv. Professional Concepts, Prioritization, Practiceenvironment, Qualitymanagement, V. Nursing Teamwork And Collaboration, Nursing Teamwork and Collaboration, Staffingandbudget, Leadershipandchange, Mentoringandprecepting, Professionaldevelopment.
Question 1 · Patientsafety
An 84-year-old patient admitted with heart failure receives furosemide twice daily and has a high fall-risk score. On two consecutive nights the patient has been found standing alone at the bedside, stating, "I have to go to the bathroom." Which intervention best addresses the cause of this fall risk?
Answer: C. Institute scheduled toileting rounds, including before sleep and at intervals through the night
Urgency from diuretic therapy is driving the unassisted night-time ambulation, so proactive, scheduled toileting targets the actual cause. Four raised side rails act as a restraint and increase injury from climbing over them, sedative-hypnotics raise fall risk in older adults, and a restraint is not justified when a less restrictive alternative addresses the need.
Question 2 · Patient/Care Management
A patient is discharged on levothyroxine and calcium carbonate. Which statement by the patient indicates a need for further teaching?
Answer: C. "I'll take my thyroid pill with my calcium and breakfast so I don't forget either one."
Calcium, iron, and food all bind or reduce the absorption of levothyroxine, so it is taken on an empty stomach 30–60 minutes before breakfast and separated from calcium by at least 4 hours. Taking all three together can leave the patient hypothyroid despite adherence.
Question 3 · Healthscreening
A 52-year-old woman admitted for cellulitis asks which preventive screenings she is due for. She has never smoked, had a normal colonoscopy 2 years ago, had a normal cervical cytology plus HPV co-test 2 years ago, and has never had a mammogram. She has no fracture history or osteoporosis risk factors. Which screening should the nurse encourage her to schedule?
Answer: B. Screening mammography
Current USPSTF guidance recommends biennial screening mammography for women aged 40 to 74, and she has never been screened. Lung cancer screening applies only to adults 50 to 80 with a significant smoking history. Routine DXA screening begins at 65 unless a younger postmenopausal woman has increased risk, and a normal co-test is repeated every 5 years, so neither is due.
Question 4 · Transitionsofcare
While completing discharge medication reconciliation, the nurse notes that the patient's home metoprolol, taken for years, does not appear on the discharge medication list, and there is no documented reason for stopping it. Which action should the nurse take?
Answer: B. Contact the provider to clarify whether metoprolol should be continued before the patient leaves
An unexplained omission is a medication discrepancy that must be resolved with the prescriber before discharge; abruptly stopping a beta-blocker can cause rebound tachycardia or ischemia, but the omission may also have been intentional. The nurse cannot independently tell the patient to resume or stop the drug. Deferring the question to follow-up leaves a known discrepancy unresolved during a high-risk transition.
Question 5 · Nursing Teamwork and Collaboration
The charge nurse is making assignments for an LPN on a medical-surgical unit. Which patient is most appropriate to assign to the LPN?
Answer: B. A patient 5 days after a laryngectomy with an established tracheostomy who needs suctioning and scheduled enteral feedings
LPNs care for stable patients with predictable outcomes and may perform established tracheostomy care, suctioning, and enteral feedings. A new admission with suspected sepsis is unstable and requires RN assessment. Blood product administration and initial discharge teaching are generally RN responsibilities, although an LPN may reinforce teaching the RN has done.
Question 6 · Patientsafety
A patient on postoperative day 2 after a laparoscopic colectomy is ambulating in the hall, tolerating fluids, and no longer requires hourly urine output measurement. An indwelling urinary catheter remains in place. The unit has a nurse-driven catheter removal protocol. Which action best reduces this patient's risk of catheter-associated urinary tract infection?
Answer: D. Remove the catheter under the protocol and monitor for spontaneous voiding
The duration of catheterization is the strongest modifiable CAUTI risk, so daily review of necessity and prompt removal under a nurse- driven protocol is the key bundle element. Routine catheter changes and irrigation do not prevent infection, and screening cultures of asymptomatic patients, especially from the bag, lead to unnecessary antibiotics.
Question 7 · Patient/Care Management
A patient with a urinary tract infection is prescribed oral ciprofloxacin and takes calcium carbonate antacid tablets for heartburn. Which instruction should the nurse give?
Answer: A. "Take the ciprofloxacin at least 2 hours before or 6 hours after the antacid."
Calcium, magnesium, aluminum, iron, and zinc chelate fluoroquinolones in the gut and markedly reduce absorption, so the doses are separated per product labeling (for ciprofloxacin, 2 hours before or 6 hours after). Taking the antibiotic with the antacid, with milk, or 30 minutes apart leaves too little time and risks treatment failure.
Question 8 · Patienteducation
A nurse is teaching an 82-year-old patient with presbycusis about new medications. Which approach is most appropriate?
Answer: A. Face the patient in a quiet room and speak in a low-pitched, clear voice
Presbycusis causes loss of high-frequency hearing first, so a lower-pitched voice, a quiet environment, and facing the patient to allow visual cues work best. Standing to the side removes facial and lip cues. Raising pitch makes speech harder to hear, and shouting distorts words and can be perceived as disrespectful.
Question 9 · Transitionsofcare
The nurse is helping the case manager identify which patient meets Medicare criteria for home health services. Which patient qualifies?
Answer: C. A patient who leaves home only for medical appointments, with great effort, and needs wound care twice weekly
Medicare home health requires that the patient be homebound (leaving home requires considerable effort and is infrequent or for medical care) and need intermittent skilled nursing or therapy under a provider's plan of care. A patient who drives to work or attends daily outpatient rehabilitation is not homebound. Help limited to bathing and meals is custodial care, which Medicare does not cover on its own.
Question 10 · V. Nursing Teamwork And Collaboration
An RN and an LPN share a team of patients. Which task is most appropriate for the RN to assign to the LPN?
Answer: B. Reinforcing insulin injection technique that the RN taught a patient the previous day
LPNs may reinforce teaching the RN has initiated for stable patients. Admission assessment of a patient transferred from intensive care, care planning, and IV push medications for a patient with an unstable rhythm require RN assessment and judgment, and IV push administration is outside LPN scope in most states.
TTP Prep has 200 CMSRN practice questions with explanations, timed and mock-exam modes, 199 flashcards, interactive lessons, a printable cheat sheet and a readiness score. Start free, no card needed.
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